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. 2011 Sep;122(3):600-3.
doi: 10.1016/j.ygyno.2011.05.041. Epub 2011 Jun 22.

Preoperative assessment of myometrial and cervical invasion in endometrial carcinoma by transvaginal ultrasound

Ozgur Akbayir  1 , Aytul Corbacioglu, Ceyhun Numanoglu, Filiz Yarsilikal Guleroglu, Volkan Ulker, Alparslan Akyol, Birgul Guraslan, Engin Odabasi
Affiliations

Preoperative assessment of myometrial and cervical invasion in endometrial carcinoma by transvaginal ultrasound

Ozgur Akbayir et al. Gynecol Oncol. 2011 Sep.

Abstract

Objective: To evaluate the diagnostic accuracy of transvaginal ultrasound (TVS) in preoperative assessment of the depth of myometrial infiltration and the presence of cervical invasion in endometrial carcinoma.

Methods: 298 consecutive patients with a diagnosis of endometrial cancer were evaluated by TVS within 3 days of surgical intervention. The depth of myometrial invasion was classified into two groups: no or <50% invasion and ≥50% invasion. Invasion of cervix was diagnosed when the neoplastic tissue distended the cervix and showed ill-defined borders with the cervical stroma.

Results: The sensitivity, specifity, positive predictive value (PPV), negative predictive value (NPV) and overall diagnostic accuracy of TVS in evaluation of the depth of myometrial infiltration were 68.4%, 82%, 65.1%, 84.1% and 77.5%, respectively. While the sensitivity and PPV were significantly higher among grade 3 tumors, the specifity, NPV and accuracy were significantly higher among grade 1 tumors. The sensitivity, specifity, PPV, NPV, and overall diagnostic accuracy of TVS in assessment of the presence or absence of neoplastic tissue in cervix were 76.5%, 99.3%, 86.7%, 98.2% and 98%, respectively. While the sensitivity and PPV were significantly higher among grade 1 tumors, the NPV and accuracy were significantly lower among grade 3 tumors.

Conclusion: TVS can be considered as a feasible, economical and simple imaging modality with a high diagnostic accuracy for the prediction of cervical involvement. However, it is not a reliable method in estimating the depth of myometrial infiltration.

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